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Tuesday, March 15, 2011
HIV/AIDS awareness often too late
Worldwide decrease flies in face of the surge in Japan among the unsuspecting, or disbelieving
By MIZUHO AOKI
More than two decades after the first case of AIDS in a Japanese patient was officially reported by the health ministry's National AIDS Surveillance Committee in 1985, HIV/AIDS seems to have become a disease of the past. With much less media coverage, people have become complacent about the issue, experts say.
"In recent years, almost no media come to cover our AIDS Day campaign, which we hold every year on World AIDS Day (Dec. 1)," said Yasushi Sawazaki, director of the Program Operation Section at the Japan Foundation for AIDS Prevention.
While the total number of newly reported HIV positive people and AIDS patients are still low in Japan compared with other countries, the number of newly HIV-infected people in Japan has doubled in the past decade.
Meanwhile, there is still no cure for AIDS and early detection of the infection is crucial, although HIV carriers today can live much longer than they did decades ago due to the development of drugs, experts say.
Following are some basic questions and answers about HIV/AIDS in Japan:
How many people in Japan are newly infected with HIV every year?
Since 2004, the number of people newly reported with HIV has topped 1,000. In 1990, 97 people were newly found to be infected. This has increased by more than a factor of 15 to 1,503 in 2010, a report by the health ministry said. It also said that in 2010, a record 453 people developed AIDS.
The figures are alarming when compared with a decline in global data. According to a report released by the Joint United Nations Program on HIV/AIDS (UNAIDS), 2.6 million people were estimated to be newly infected with HIV in 2009, down from an estimated 3.1 million in 1999.
In Japan, about 50 percent of HIV-positive people, excluding those who developed AIDS symptoms, were infected through homosexual sexual contact and about 30 percent were infected through heterosexual sexual contact, as of December 2010, according to the government's National AIDS Surveillance Committee.
What's also alarming is the slight increase in people who found out about their infections after they developed AIDS symptoms, said Sawazaki of JFAP. In 2010, about 30 percent of new HIV carriers found out about the infection after they developed AIDS symptoms. The percentage has increased two years in a row since 2008.
Early detection is very important, experts say, adding that the faster one finds out about HIV, the more control one has over the virus.
Where can HIV tests be taken?
Most public heath centers nationwide offer free and anonymous HIV tests.
In most cases, the centers offer HIV tests during the daytime on weekdays, and generally reservations are required.
But some centers offer HIV tests at later hours and for those who don't have reservations.
In Tokyo, for example, the Tokyo Metropolitan Minami-Shinjuku Testing and Counseling Office (03) 3377-0811 offers HIV tests between 3:30 and 7:30 p.m. on weekdays, and between 1 and 4:30 p.m. on weekends, free of charge but reservations are required.
Information about a local health center or a clinic that best suits one's schedule is available on the HIV Kensa Sodan Map (HIV testing and counseling map) website (www.hivkensa.com) run by the health ministry.
The website also provides information about HIV test campaigns that public health centers usually hold during the weekends to provide a more convenient time for working people.
HIV tests can also be taken at some clinics, but they charge a fee that ranges from around ¥5,000 to ¥10,000.
Also, Dr. Tsuneo Akaeda of Akaeda Roppongi Clinic offers free HIV tests at clubs in and around Roppongi during limited times and dates. See www.akaeda.com/volunteerstreetInspection.
When can HIV test results be expected?
As for rapid HIV testing, it takes about 30 minutes to get the results. As for a conventional HIV test, it takes one or two weeks to get the result because it involves a different screening method, meaning people have to visit the test center again to receive the results.
According to Sawazaki, both methods have the same level of accuracy.
If test results are positive, regardless of which test was taken, the blood sample goes through another test for confirmation, using different and more accurate methods, such as the Western blot technique.
Results from this second test will take about a week.
Not all public health care centers or clinics provide speedy HIV tests, so please check with each institution.
When should one have an HIV test?
Experts recommend people wait for three months after the day of a possible infection with HIV.
HIV tests conducted during the so-called window period, which is between the time of one's exposure to HIV and HIV antibodies appearing in the blood, may give false negative results due to the lack of detectable antibodies, experts said.
If someone is aware of having had sexual contact with an HIV carrier, isn't there anything that can be done besides waiting three months to get tested and to start treatment?
If one suspects having had sexual contact with an HIV carrier, it may be possible to prevent infection by taking certain drugs within about 72 hours after exposure, explained Miwako Honda, a physician at the AIDS Clinical Center of the National Center for Global Health and Medicine.
One should take the drugs for 30 days at a cost of about ¥200,000, Honda said.
The cost will not be covered by insurance and people can purchase the drugs only at select hospitals, including the National Center for Global Health and Medicine in Tokyo.
"It's not a 100 percent effective measure, but in some cases, HIV infection can be prevented," Honda said.
How much does it cost to get medication for HIV?
HIV-positive people don't have to take drugs until their immune system weakens below a certain level.
Until reaching that state, HIV carriers only have to visit a hospital once every two to three months to monitor their immune system.
Roughly speaking, on average, such medication costs about ¥200,000 a month, meaning about ¥2.4 million per year, explained Honda. However, 70 percent of the cost will be covered by national health insurance and additional financial support will be provided to those issued a physical disability certificate, Honda said.
How is a physical disability certificate obtained?
HIV-positive people can apply for a physical disability certificate at local government offices if they bring a doctor's certificate and ID photos.
For a physical disability certificate, there are four degrees of disability, depending on health conditions. If one meets certain requirements, one will receive a physical disability certificate regardless of nationality.
Is there any language support about HIV/AIDS for foreigners in Japan?
JFAP provides a 24-hour automated support line for HIV/AIDs information in Japanese, English, Spanish, Portuguese, Thai, Chinese, Korean and Tagalog.
The automated system provides information for 39 different topics regarding HIV/AIDS, including basic knowledge of the disease, where one can get tested, HIV treatment and social services. Call (03) 5940-2127 or (078) 265-6262 to access the service.
Also, several AIDS support groups provide foreign languages support. For example, to get English-language support, call Tokyo English Life Line at (03) 5774-0992. They operate every day from 9 a.m. to 11 p.m.
What kinds of measures are taken in Japan to raise people's awareness?
Since 2006, the health ministry has been running HIV test awareness campaigns during the first week of June.
During that week, local health centers offer special HIV tests at later hours on weekdays as well as on weekends.
Also, JFAP holds its AIDS awareness campaign around World AIDS Day on Dec. 1, posting advertisements and handing out free condoms to passersby.
Around these campaign days, more people take HIV tests, but the awareness doesn't last for long.
Sawazaki of JFAP and Honda of the AIDS Clinical Center occasionally visit junior high and high schools to give talks about HIV/AIDS to children, and they say some HIV carriers also visit schools.
"But still, not many people come out and say they are HIV positive. . . . I think it's better if HIV-positive people can give talks (directly to children) in classrooms," Sawazaki said.